Cardiometabolic risk factors in type 2 diabetes with high fat and low muscle mass: At baseline and in response to exercise

Obesity (Silver Spring). 2017 May;25(5):881-891. doi: 10.1002/oby.21808. Epub 2017 Mar 20.


Objective: To examine the interplay between high fat and low muscle mass on cardiometabolic risk factors at baseline and in response to exercise in type 2 diabetes.

Methods: Using baseline percent body fat and skeletal muscle mass index, 248 participants were divided into high fat versus low fat and low muscle versus high muscle. Linear mixed models were used to examine the main effects of fat mass and muscle mass and their interaction on baseline cardiometabolic risk factors and changes in risk factors in response to 6-month exercise training.

Results: At baseline, there was a fat mass by muscle mass interaction effect on hemoglobin A1c (HbA1c ; P = 0.009), suggesting that low muscle was associated with elevated HbA1c in those with high fat but not low fat. Significant interactions between baseline fat mass and muscle mass on the exercise-induced changes in visceral adipose tissue, insulin resistance, and triglyceride concentration indicated that low muscle attenuated the exercise responses in participants with high fat at baseline (all P < 0.05).

Conclusions: High fat and low muscle may be synergistically associated with higher HbA1c in type 2 diabetes. In participants with high fat mass, low muscle mass may attenuate exercise-induced improvements in some cardiometabolic risk factors.

Trial registration: NCT00195884.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Diabetes Mellitus, Type 2 / complications*
  • Exercise / physiology*
  • Female
  • Heart Diseases / etiology*
  • Humans
  • Intra-Abdominal Fat / metabolism*
  • Male
  • Metabolic Diseases / etiology*
  • Middle Aged
  • Muscle, Skeletal / metabolism*
  • Risk Factors

Associated data